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Public notice regarding renewal of the Traumatic Brain Injury Waiver

Posted Sep 15, 20223 min Read

Payment & Reimbursement Regulatory & Clinical

In accordance with public notice requirements established at 42 CFR 447.205, the Indiana Family and Social Service Administration Office of Medicaid Policy and Planning and the Division of Aging intends to submit a renewal for the Traumatic Brain Injury waiver to the Centers for Medicare and Medicaid Services for consideration.

The Traumatic Brain Injury waiver provides Medicaid home-and community-based services to eligible participants in a range of community settings as an alternative to care in a nursing facility. The waiver is designed to provide services to supplement informal supports for persons who would require care in a nursing facility if waiver or other supports were not available. The program permits a state to furnish an array of home-and community-based services that assist Medicaid beneficiaries to live in the community and avoid institutionalization.

Waiver participants must meet the minimal level of care requirements for that of a nursing facility and have a diagnosis of Traumatic Brain Injury. Indiana defines a traumatic brain injury as a trauma that has occurred as a closed or open head injury by an external event that results in damage to brain tissue, with or without injury to other body organs. Traumatic brain injury means a sudden insult or damage to brain function, not of a degenerative or congenital nature.

The Family and Social Services Administration Office of Medicaid Policy and Planning and Division of Aging proposes to renew the Traumatic Brain Injury waiver as currently implemented. There are no new waiver or service provisions being requested for this renewal request. The 2023 fiscal impact and projected 2024 waiver fiscal impact include the following:

Fiscal Impact (in millions):

  • Federal Budget Impact:                      SFY 2023 $ 5.03         SFY 2024 $ 4.85
  • State Budget Impact:                          SFY 2023 $ 2.27         SFY 2024 $ 2.54
  • Federal Budget Impact:                      FFY 2023 $ 4.90         FFY 2024 $ 4.89
  • State Budget Impact:                          FFY 2023 $ 2.39         FFY 2024 $ 2.55

Additional budget information can be found in Appendix J of the Traumatic Brain Injury Waiver renewal. The public comment period for the Traumatic Brain Injury waiver renewal began Aug. 3, 2022, and will run through Sept. 30, 2022. The renewal is provided in the following public notice formats:

  1. A full copy of the TBI renewal waiver is posted on the on the FSSA’s Division of Aging Draft Policies for Public Comment webpage and on the FSSA’s Division of Aging Medicaid HCBS webpage
  2. A non-electronic notice is provided via the Indiana Register at – 20220803-IR-405220236ONA.xml.pdf
  3. Paper copies of the TBI renewal waiver are available upon request at local Division of Family Resources offices as well as local Area Agency on Aging offices.

Comments may be emailed to or mailed to the address below:

FSSA–Division of Aging
RE: TBI Waiver Renewal Public Comment
402 West Washington Street, Room W454
P.O. Box 7083
Indianapolis, IN 46207